Redefining the Reserve Response

Abstract

Following years of draw-downs in the Department of Defense and with domestic terrorism now likely to recur since September 2001, this nation needs to rethink and redefine calling in the Reserves for medical responses to terrorism. Neither local civilian emergency medical services nor hospitals could handle a mass casualty event anticipated from terrorist attacks. The mission of the National Guard should not be unduly augmented to include medical care of casualties in the aftermath of terrorist attacks when we have a substantial Reserve medical force across the Department of Defense services. Typically, we think of Reservists as only needed if a war or conflict occurs outside our nation. Despite Reservist medical personnel performing nearly all worldwide U.S. humanitarian missions, Reservists are perceived as persons we begrudge on our taxpayer dollars while they await the call to truer duty. In terms of our highly trained (both civilian and militarily) medical Reservists across the armed forces and commissioned public health system, we need to understand how skilled and truly expert many of them are already. Add the military context and you have the new Ready Reservist in the various health care corps. These are our modern first responders to domestic terrorism in which civilian medical casualties would otherwise be overwhelming to limited civilian hospital, emergency medical services, and public health services. The need for a new paradigm accepted by everyone in the new Homeland Security chain-civilian local authorities to state to federal to Department of Defense-absolutely will be key to our national survival and recovery following any future domestic attacks.